Using Augmented Reality for the Treatment of Borderline Personality Disorder

Abstract

Borderline Personality Disorder (BPD) is a complex and chronic psychiatric condition characterized by emotional dysregulation, impulsivity, unstable interpersonal relationships, and high rates of self-harm and suicidality [1]. Traditional treatment relies heavily on intensive psychotherapies such as Dialectical Behaviour Therapy (DBT), Mentalization-Based Therapy (MBT), and Schema Therapy (ST), which, while effective, require long-term commitment and significant professional resources. As a result, nearly half of BPD patients do not reach symptom remission, and accessibility and treatment adherence remain critical concerns [2]. Moreover, current approaches are often unable to adequately address the disorder’s clinical heterogeneity, exacerbated by a high comorbidity with other psychiatric conditions.

Therefore, there is a growing need to explore novel, accessible and scalable treatment strategies that reduce dropout rates and extend therapeutic access. While virtual reality (VR) and augmented reality (AR) have shown promise in treating anxiety and PTSD, their application to BPD remains underexplored [3]. Particularly, AR offers a unique opportunity to enhance therapeutic engagement by allowing patients to interact with real-time immersive environments that incorporate emotional triggers, social scenarios, and physiological feedback. Thus, the research question we aim to answer is can AR/VR based technologies be used to ameliorate BPD symptomatology and complement the treatment effectively, as well as potentially serve as a tool to collect valuable clinical data?

This research project presents a cross-sectional investigation of AR-based interventions as an adjunctive tool for BPD treatment. The study begins with a systematic review of the current state-of-the-art on BPD therapies and emerging AR-based techniques. We then aim to develop and evaluate an AR prototype grounded in existing DBT and MBT protocols, integrated with real-time biofeedback to facilitate emotion and impulse regulation training. Additionally, the study explores the use of breathwork and auto-suggestion to further enhance autonomic regulation and cognitive flexibility in our proposed framework. Lastly, we will see if the system can be used as a data collection tool. There will be no patient cohort in this project, but we consider an extension into longitudinal study for further research.

By combining most effective self-regulation techniques with immersive and personalized AR environments, this research seeks to develop a novel, scalable, and more accessible treatment strategy tailored to BPD’s unique symptomatology. While we are aware of possible ethical implications, the long-term goal is to reduce therapy attrition and improve emotional resilience in patients through adaptive, accessible, and cost-effective digital intervention.

References

[1] J. Confue, I. Maidment, S. Jones, and M. Jones, “Factors That Influence Prescribing in Borderline Personality Disorder: A Systematic Review,” Personality and Mental Health, 2025.

[2] F. Leichsenring et al., “Borderline Personality Disorder: A Comprehensive Review of Diagnosis and Clinical Presentation, Etiology, Treatment, and Current Controversies,” World Psychiatry, 2024.

[3] B. Cieślik, J. Mazurek, S. Rutkowski, P. Kiper, A. Turolla, and J. Szczepańska-Gieracha, "Virtual reality in psychiatric disorders: A systematic review of reviews," Complement The. Med, 2020.